Provider Demographics
NPI:1861839706
Name:ALLRED, CARLY A (MD)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:A
Last Name:ALLRED
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4007 JAMES CASEY ST
Mailing Address - Street 2:STE A220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-3335
Mailing Address - Country:US
Mailing Address - Phone:512-447-4993
Mailing Address - Fax:512-472-9688
Practice Address - Street 1:1250 E MARSHALL ST
Practice Address - Street 2:SURG: GENERAL SURGERY CLINIC
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-5051
Practice Address - Country:US
Practice Address - Phone:804-828-7391
Practice Address - Fax:804-828-0191
Is Sole Proprietor?:No
Enumeration Date:2013-06-02
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXR7375208600000X
VA390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program